To the Editor: We have some concerns regarding the randomized controlled trial by Dr Lenze and colleagues,1 which investigated the efficacy of escitalopram for the treatment of generalized anxiety disorder (GAD) in older adults. First, it is not clear why the primary efficacy analysis was based on the Clinical Global Impression-Improvement scale. Patients were included based on a cutoff score on the Hamilton Anxiety Rating Scale, and change in score on this more specific scale is usually recommended as the primary outcome measure in studies of GAD.2 Also, only weekly change in the Hamilton Anxiety Rating Scale was presented as a secondary outcome measure. Overall change from baseline to end point would have facilitated the interpretation of the results.
Schwan S, Hallberg P. Escitalopram Treatment of Generalized Anxiety Disorder in Older Adults. JAMA. 2009;301(19):1987-1988. doi:10.1001/jama.2009.651